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Total Results: 4,019 records

Showing results for "mistakes".

  1. Missed Patient Assignment: Is Anyone There? | PSNet

    psnet.ahrq.gov/web-mm/missed-patient-assignment-anyone-there
    September 01, 2017 - illusion of understanding," which can occur when highly trained, conscientious clinicians make simple mistakes

  2. TeamSTEPPS Building Block Exercise Instructions (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-exercise-instructions.pdf
    June 02, 2025 - • The concept of feedback and its role in correcting mistakes.

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/853773/psn-pdf
    September 27, 2023 - Potential solutions are to provide counseling, to create a “safe place” to learn from mistakes without

  4. AHRQ Safety Program for MRSA Prevention

    www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/156-what-are-4es.pptx
    October 01, 2024 - Learn from mistakes. Maintain open lines of communication.

  5. TeamSTEPPS Pocket Guide (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/teamstepps-pocket-guide.pdf
    May 01, 2023 - actions and stress levels of other team members y Providing a safety net within the team y Ensuring that mistakes

  6. Assemble the Team and Engage Leadership for Perinatal Safety | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/assemble-slides.html
    July 01, 2023 - that their environment supports the interpersonal risk involved in asking for help or learning from mistakes

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/843151/psn-pdf
    February 01, 2023 - will not be punished, humiliated or discounted for speaking up with ideas, questions, concerns, or mistakes

  8. Innovations | PSNet

    psnet.ahrq.gov/innovations
    February 26, 2025 - Error Types Active Errors (7) Cognitive Errors ("Mistakes

  9. Low on the Totem Pole | PSNet

    psnet.ahrq.gov/web-mm/low-totem-pole
    October 01, 2003 - Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes.

  10. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose | PSNet

    psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
    March 15, 2023 - intercepting errors. 6 Some healthcare professionals thus question their impact on safety, arguing that mistakes

  11. COVID-19: Team and Human Factors to Improve Safety | PSNet

    psnet.ahrq.gov/primer/covid-19-team-and-human-factors-improve-safety
    September 15, 2024 - when workflows for new processes are being developed in order to proactively avert opportunities for mistakes

  12. Diagnostic Safety Centers of Excellence Grants Awarded in FY 2022 | Agency for Healthcare Research and Quality

    www.ahrq.gov/diagnostic-safety/research/grants-2022.html
    July 01, 2025 - Discusses EHR usability issues contributing to diagnostic mistakes and offers design and training improvements

  13. Develop and Validate Health IT Safety Measures To Capture Violations of the Five Rights of Medication Safety | Digital Healthcare Research

    digital.ahrq.gov/ahrq-funded-projects/develop-and-validate-health-it-safety-measures-capture-violations-five-rights
    January 01, 2023 - While capturing the instance of retracting and reordering mistakes does not correct or prevent errors

  14. Evidence in Use of Clinical Reasoning Checklists for Diagnostic Error Reduction (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/diagnostic-error-reduction.pdf
    September 04, 2020 - Finding and fixing mistakes: do checklists work for clinicians with different levels of experience?

  15. Patient Safety Tools | Agency for Healthcare Research and Quality

    www.ahrq.gov/research/findings/evidence-based-reports/makinghcsafer.html
    June 01, 2022 - Medicine that confirms that acute and chronically fatigued medical residents are more likely to make mistakes

  16. Spotlight

    psnet.ahrq.gov/sites/default/files/2024-07/spotlight_case_mismanagement_of_acute_decompensated_heart_failure_slides_final.pptx
    January 01, 2024 - Proper use of checklists, treatment algorithms, or clinical decision support tools might prevent similar mistakes

  17. Techno Trip | PSNet

    psnet.ahrq.gov/web-mm/techno-trip
    May 01, 2005 - the Same Author(s) WebM&M Cases Diagnosing Diagnostic Mistakes

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/863650/psn-pdf
    February 28, 2024 - requires additional treatment decisions.2 The complex care provided in the ICU increases the risk of mistakes

  19. Wrong Catheter in the Right Patient | PSNet

    psnet.ahrq.gov/web-mm/wrong-catheter-right-patient
    May 16, 2022 - blood products, implants, devices, and special equipment needs, should be identified. 9 Scheduling mistakes

  20. Re-engineering the Hospital Discharge: An Example of a Multifaceted Process Evaluation (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Anthony.pdf
    January 01, 2005 - skill-based behaviors are needed for optimal care, there are many opportunities for slips, lapses, mistakes
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